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. 2012 Mar 19:12:15.
doi: 10.1186/1471-2393-12-15.

Community based weighing of newborns and use of mobile phones by village elders in rural settings in Kenya: a decentralised approach to health care provision

Peter Gisore  1 , Evelyn Shipala, Kevin Otieno, Betsy Rono, Irene Marete, Constance Tenge, Hillary Mabeya, Sherri Bucher, Janet Moore, Edward Liechty, Fabian Esamai
Affiliations

Community based weighing of newborns and use of mobile phones by village elders in rural settings in Kenya: a decentralised approach to health care provision

Peter Gisore et al. BMC Pregnancy Childbirth. .

Abstract

Background: Identifying every pregnancy, regardless of home or health facility delivery, is crucial to accurately estimating maternal and neonatal mortality. Furthermore, obtaining birth weights and other anthropometric measurements in rural settings in resource limited countries is a difficult challenge. Unfortunately for the majority of infants born outside of a health care facility, pregnancies are often not recorded and birth weights are not accurately known. Data from the initial 6 months of the Maternal and Neonatal Health (MNH) Registry Study of the Global Network for Women and Children's Health study area in Kenya revealed that up to 70% of newborns did not have exact weights measured and recorded by the end of the first week of life; nearly all of these infants were born outside health facilities.

Methods: To more completely obtain accurate birth weights for all infants, regardless of delivery site, village elders were engaged to assist in case finding for pregnancies and births. All elders were provided with weighing scales and mobile phones as tools to assist in subject enrollment and data recording. Subjects were instructed to bring the newborn infant to the home of the elder as soon as possible after birth for weight measurement.The proportion of pregnancies identified before delivery and the proportion of births with weights measured were compared before and after provision of weighing scales and mobile phones to village elders. Primary outcomes were the percent of infants with a measured birth weight (recorded within 7 days of birth) and the percent of women enrolled before delivery.

Results: The recorded birth weight increased from 43 ± 5.7% to 97 ± 1.1. The birth weight distributions between infants born and weighed in a health facility and those born at home and weighed by village elders were similar. In addition, a significant increase in the percent of subjects enrolled before delivery was found.

Conclusions: Pregnancy case finding and acquisition of birth weight information can be successfully shifted to the community level.

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Figures

Figure 1
Figure 1
Location of the Global Network - Kenya site. The left panel depicts each of the 16 clusters. Each dot represents an individual village headed by a village elder. The right panel shows where within Kenya the clusters are located.
Figure 2
Figure 2
Top panel shows the percent of infants in each month that had an actual birth weight recorded. The lower panel shows the percent of pregnancies in each month enrolled after the birth date.
Figure 3
Figure 3
Box-plot of birth weight distributions for infants born and weighed in a health facility and those born at home and weighed by a village elder. The box encloses 25th to 75th percentile, and whiskers denote 1st quartile - 1.5(interquartile range) and 3 rd quartile + 1.5(interquartile range). Medians were compared by Wilcoxon test.
See this image and copyright information in PMC

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